| NPI | 1962260737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide (Licence: OH UP722196) |
| Additional Taxonomies | 376J00000X Homemaker (Licence: OH UP722196) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-03-07 |